Journal of Advanced Nursing最新文献

Aim: This study aimed to test the psychometric properties of the Self-Care of Chronic Illness Inventory and the Self-Care Self-Efficacy scale in patients with cancer.

Design: A multisite cross-sectional validation study was conducted.

Methods: Between November 2022 and July 2023, a convenience sample of 318 patients with cancer were enrolled in five Italian inpatient and outpatient facilities. Confirmatory factor analysis was performed on the three scales of the Self-Care of Chronic Illness Inventory and the Self-Care Self-Efficacy scale. Internal consistency was tested using Cronbach's alpha for unidimensional scales and McDonald's Omega for multidimensional scales. Construct validity was assessed with the global health status by Pearson's correlation. The COnsensus-based Standards for the selection of health Measurement INstruments reporting guidelines were followed for the reporting process.

Results: Three hundred fourteen patients were included (median age: 55.5 years; male: 53.82%). Confirmatory factor analysis showed supportive fit indices for the three Self-Care of Chronic Illness Inventory scales (CFI: 0.977-1.000; SRMR: 0.004-0.78) and the Self-Care Self-Efficacy scale (CFI: 1.000; SRMR: 0.014). All scales demonstrated adequate internal consistency (0.89-0.99) and test-retest reliability (0.85-0.95). Construct validity was confirmed through correlations between Self-Care Self-Efficacy, each Self-Care of Chronic Illness Inventory scale, and global health status.

Conclusion: The Self-Care of Chronic Illness Inventory and Self-Care Self-Efficacy scales demonstrated excellent psychometric qualities and construct validity when administered to patients with cancer. Future research should explore self-care behaviours across different diseases and cultural contexts.

Implications for the profession: These tools can help develop targeted educational programs, improving patient outcomes.

Impact: Currently, there is a lack of knowledge regarding self-care behaviours in patients with cancer. These tools enable healthcare professionals to identify patient needs, design personalised interventions, and monitor their effectiveness over time.

Patient or public contribution: No patient or public contribution.

1 Introduction

Equity and diversity are increasingly recognised as critical issues in the nursing profession. One important focus has been gender equity (Padgett 2024). As a female-dominated profession, nursing has benefitted from feminist advocacy, which has played an important role in addressing systemic inequities and advancing the rights of women in nursing (Chinn 1985). However, as more men choose nursing as a career, contradictory debates have ensued about the relative advantages or disadvantages faced by men compared to women (Padgett 2024). These include claims of disadvantage and inequity for men, who make up the minority of nurses (comprising about 10% worldwide) (World Health Organization (WHO) 2020). On the other hand, there are assertions of systemic privileges for men, evidenced by advantages in pay and career progression within nursing (Punshon et al. 2019; Doleman et al. 2024). Although claims of systemic disadvantages for men are less robust, they are persistently articulated in the nursing literature (Padgett 2024).

While addressing pay and career progression disparities remains a priority, we argue in this paper that building a more equitable and inclusive profession, and tackling oppressive systems and hierarchies, requires embracing a more nuanced understanding of gender relations and gender diversity. Importantly, we argue that a simplistic and dichotomous view of gender risks obscuring pressing equity issues related to the dynamic and sometimes abrasive intersections of gender, race, class, sexuality and other social structures (Carbado et al. 2013) and overlooks nurses' personal agency in resisting structural power dynamics to support gender equity (Fisher 2006). Moreover, gender is not binary, and trans and gender-diverse people are increasingly seeking visibility, recognition and equity within the nursing profession (Kellett and Fitton 2016; Quinn et al. 2021). Therefore, we argue that the focus of nursing should be on cultivating a reflexive and inclusive culture and addressing systemic inequity for nurses from diverse backgrounds, including those related to pay disparities, underrepresentation in leadership and unequal access to opportunities.